Intra-operative use of Bispectral Index Monitoring and Time to Extubation and Patients Length of Stay after Cardio Pulmonary Bypass Surgery, at An-Najah National University Hospital / Nablus /Palestine. A Randomized Control Study

Background: The primary goal of cardiac surgery is not just a minimally acceptable outcome where the patient survives without life threatening complications, but a healthy productive long term survivor. There is no universally accepted technique for anesthesia management during cardiac surgery,Anesthetic protocols in cardiac surgery are investigated and analyzed in terms of their effect on post-operative
mortality and incidence of myocardial infarction following cardiac surgery, needs for inotropic support, time to extubation, time on mechanical ventilation, and hospital length of stay. Fast–track tracheal extubation (within 6 hours after the surgery) after cardiac surgery has become a methods which is believed to facilitate this must be validated. One of these methods, is the use of intra-operative monitoring Modalities, such as (BIS) which is a value derived from electroencephalogram, and had been used as a measure of anesthesia effect. We performed this study in An-najah National University Hospital / Palestine to investigate the role of BIS monitoring on time to extubate and CCU length of stay after cardiopulmonary bypass surgery.
Methods: In a randomized control study we used the bispectral index monitoring during cardiopulmonary bypass between 40-50 and in the CCU between 60-70 until extubation. 100 patients between the age of 30 and 75 years undergoing elective cardiopulmonary bypass surgery and patients undergoing elective valve replacement or repair, from 01/10/2015 to 01/04/2016 were assigned for this study, randomized to 50 patients each in the BIS group and the conventional group.
Results: Extubation time data were available for 100 patients. The median time to extubate (320) minutes in the BIS group and (365) minutes in conventional group. The median CCU length of stay (24.1) hours in BIS group and (24.3) hours in conventional group. Regarding hospital length of stay, there was no difference in between the two groups, with median time of (5 days) in both groups.
Conclusions: Data from this study suggested that the use of the BIS monitor during cardio pulmonary bypass does not confer an advantage in reducing time to extubation, CCU length of stay, or overall hospital length of stay.


Wael Abdullah Sadaqa, Saleem Haj Yahia, Wafiq Othman, Mahmoud Zaghari, Abdelbaset Nazzal, RMohammad Jaber, Haitham Aqraa and Fatima Khaleel sakhli

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